Soft-Tissue Balance in Revision Total Knee Arthroplasty

Medial and lateral soft-tissue releases to correct varus and valgus deformities in primary total knee arthroplasty are achieved by sequential release of contracted soft-tissue constraints or, occasionally, advancement of elongated ligaments1-3. In primary total knee arthroplasty, soft-tissue constraints are typically well-defined anatomical structures, whereas, in revision total knee arthroplasty, the soft-tissue constraints may be thickened and scarred, attenuated, or absent. Soft-tissue balance in revision total knee arthroplasty is achieved by a combination of soft-tissue releases and variation in the bone resection level, implant position, and implant size4.